Solution
Interoperability compliance architecture
For payers, Medicaid programs and the vendors who serve them, facing federal API and prior-authorization deadlines.
What it is. A target-state architecture and delivery plan for the Patient Access, Provider Access, Payer-to-Payer and Prior Authorization APIs: data mapping from claims and clinical sources, consent and attribution handling, API security, operational metrics reporting, and the vendor-versus-build decisions in between.
Why it works. We treat the regulation as a requirements document and the deadline as an architecture deadline. Compliance built this way becomes a reusable data-exchange foundation rather than a one-time project.
Read: Interoperability deadlines are architecture deadlines →
Solution
Trusted exchange readiness & onboarding
For state HIEs, health systems, FQHCs, public health agencies and digital health vendors preparing to participate in nationwide trusted exchange.
What it is. A readiness assessment against participant obligations, a gap analysis across identity, exchange purposes, security and audit, and an onboarding architecture that covers connectivity, record location, consent handling and monitoring.
Why it works. Network participation is as much a governance exercise as a technical one. We design for both, including the controls that let you demonstrate trust rather than merely attest to it.
Read: Transport trust is not actor trust →
Solution
Caregiver & delegated access architecture
For health systems, care-management programs, payers and consumer health applications serving older adults and people with complex conditions.
What it is. An end-to-end design for verified caregiver access: identity proofing at the required assurance level, consented proxy relationships modeled in standard resources, scoped data access, point-of-care sharing and full disclosure logging.
Why it works. Most portals treat caregivers as an afterthought bolted onto patient login. Designing delegation as its own use case produces something families can use and compliance teams can defend.
Read: Delegated access is a design problem →
Solution
Legacy modernization & cloud migration
For hospitals, agencies and research programs running aging platforms that are expensive to maintain and risky to change.
What it is. Portfolio assessment, technical-debt inventory, migration-path analysis (including the honest case for lift-and-shift where it is the right call), target-state design in regulated cloud environments and a phased plan that keeps operations running.
Why it works. Modernization fails when it is sequenced by vendor roadmap instead of business value. We sequence by value, risk and the organization's real capacity to absorb change.
Read: Lift-and-shift is a decision, not a default →
Solution
Architecture governance operating model
For federal and state programs, large health systems and any organization whose review board has become a bottleneck or a rubber stamp.
What it is. Design or redesign of architecture and technical review functions: intake, complexity classification, review tiers, standards, decision records and the metrics that show whether governance is improving decisions or just adding steps.
Why it works. We classify work by how much deliberation a decision needs, not by how technically hard the project is. Routine work moves fast; contested decisions get real attention.
Read: Measure governance by review burden →
Solution
Program eligibility & navigation tools
For community organizations, plans, care-management programs and consumer health companies helping people find and enroll in the programs they qualify for.
What it is. A rules-engine-driven screener and navigator architecture with a plugin registry for programs, stateless-by-default design to avoid unnecessary data persistence, and output framed as pre-screening rather than determination.
Why it works. Programs multiply and rules change. Separating the rules from the experience keeps the tool current without constant rebuilds, and the privacy posture keeps it out of regulatory trouble.
Solution
EHR integration & clinical workflow optimization
For health systems and physician groups whose clinicians are carrying the cost of disconnected systems.
What it is. Integration of care-coordination, scheduling, reminder and insight applications into the EHR using SMART on FHIR and standard interfaces, with workflow analysis that identifies where technology adds burden and where it removes it.
Why it works. Measured results from this work include double-digit improvements in scheduling efficiency, no-show rates and provider burden. The method is the same every time: start in the workflow, not in the integration spec.